The purpose of this research is to investigate the impact of professional and nonprofessional unionism on the delivery of health services, professional staff organizations and the administration of governmental and voluntary hospitals. Utilizing a sample of approximately 36 hospitals in six cities (selected from among 1100 unionized hospitals with labor/management agreements previously identified by AHA) we will investigate the impact of professional and nonprofessional unions on the relative prices of factor inputs, the effect of these cost changes on the allocation of manpower and substitution of capital for labor or one type of labor for another, the impact of work rules on health care delivery, the effect of unionism on the formulation and application of health care policy, and the impact of unionism on the role and authority of administrators, physicians, and other professional staff. Contrary to the existing literature this study postulates a multilateral as opposed to bilateral collective bargaining model to describe the labor relations process in governmental and voluntary hospitals. This distinction is significant for board members, administrators. professional staff, legislators, and third party neutrals attempting to understand the nature and use of power and the impact of unions. The recent Taft Hartley amendments bring the possibility of collective bargaining to all voluntary hospitals. Third party dispute resolution mechanisms in the act make authoritative information on impact and process essential. This study fills two major gaps in the existing literature: systematic information on professional unionism (salaried physicians, interns and residents, pharmacists and occupational specialties) and on systematic information on impact. The current literature deals with neither.